Serviço Cirurgia Geral, Hospital Garcia de Orta, Almada, Portugal.
Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Mediators Inflamm. 2021 Oct 18;2021:4194859. doi: 10.1155/2021/4194859. eCollection 2021.
IgE mediates type I hypersensitivity reaction and can be found in the mucosa of organs affected by allergy. Acute appendicitis (AA) is a common disease, but its etiology remains poorly understood. Here, we investigated IgE deposition in histological sections of AA samples to test the hypothesis that an allergic reaction may substantially contribute to the pathophysiology of AA.
In a retrospective study, we assessed the presence of IgE in appendicular specimens of histologically confirmed appendicitis and in the control group, comprised of negative appendicitis and incidental appendectomies, using a monoclonal antibody against human IgE. Samples from 134 appendectomies were included: 38 phlegmonous and 27 gangrenous appendicitis from the study group and 52 incidental appendectomies and 17 negative appendicitis from the control group. The slides were visualized by light microscopy, and a standard procedure was used to manually count the positive IgE staining cells.
IgE staining was present in the cells of all but 5 appendicular specimens. We found a significantly increased number of IgE-positive cells in phlegmonous AA (median = 28) when compared to incidental appendectomy (median = 17) ( = 0.005; < 0.0001 when adjusted for age and gender). No difference was found for gangrenous appendicitis. . The presence of IgE supports the contribution of an allergic reaction for the pathophysiology of phlegmonous appendicitis. The reduced number of IgE staining cells in gangrenous appendicitis can be due to tissue destruction, or, as been claimed by others, gangrenous appendicitis is a distinct entity, with different etiology.
In this study, phlegmonous appendicitis had the highest number of IgE-positive appendicular cells. These findings suggest that an allergic reaction can contribute to the pathophysiology of AA, opening a novel possibility for preventive measures in a disease that typically requires surgery.
IgE 介导 I 型超敏反应，可存在于受过敏影响的器官黏膜中。急性阑尾炎（AA）是一种常见疾病，但病因仍不清楚。在这里，我们研究了 AA 样本组织学切片中的 IgE 沉积，以检验过敏反应可能对 AA 的病理生理学有重大贡献的假设。
在一项回顾性研究中，我们使用针对人 IgE 的单克隆抗体，评估了组织学证实的阑尾炎患者阑尾标本和对照组阑尾标本（包括阴性阑尾炎和偶然阑尾切除术）中 IgE 的存在。共纳入 134 例阑尾切除术标本：研究组包括 38 例蜂窝织炎性和 27 例坏疽性阑尾炎，对照组包括 52 例偶然阑尾切除术和 17 例阴性阑尾炎。通过光学显微镜观察切片，并使用标准程序手动计数阳性 IgE 染色细胞。
除了 5 个阑尾标本外，所有阑尾标本的细胞中均存在 IgE 染色。与偶然阑尾切除术（中位数=17）相比，蜂窝织炎性 AA 中 IgE 阳性细胞的数量显著增加（中位数=28）（=0.005；调整年龄和性别后 <0.0001）。坏疽性阑尾炎则无差异。IgE 的存在支持过敏反应对蜂窝织炎性阑尾炎病理生理学的贡献。在坏疽性阑尾炎中，IgE 染色细胞数量减少可能是由于组织破坏，或者正如其他人所声称的那样，坏疽性阑尾炎是一种不同的实体，具有不同的病因。
在这项研究中，蜂窝织炎性阑尾炎的 IgE 阳性阑尾细胞数量最多。这些发现表明，过敏反应可能有助于 AA 的病理生理学，为通常需要手术的疾病提供了预防措施的新可能性。
